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  ACCOUNT SET-UP



WORK WEAR SAFETY SHOES
  • Branded for Safety Our primary business for over 25 years is supplying OSHA approved safety footwear.
  • We supply the top safety shoe brands: WOLVERINE, HyTest, Timberland, Converse, Harley Davidson, Justin Boots, CAT, Florsheim, Dr. Martens & more...
ON-SITE
OSHA Standards, Compliance & Safety Presentation On site Hazard Assessments (OSHA 1910.132 )
  • Employee Training and fitting for protective footwear compliance (OSHA 1910.132)
  • Foot protection - (OSHA 1910.136)
  • Safety Footwear Technology Training
Distribution & Services
  • "Shoemobile - We Bring the Shoe Store to Your Door!"
  • On site sales & promotion of safety footwear.
  • Web based services include 'personalized' company safety web sites.
  • Mail order Services
  • Retail Sales
Billing - Corporate Accounts
  • Statements and Invoices sent via email in pdf format.
  • Voucher system with control numbers security protected with watermark.
  • Corporate purchase orders welcome
  • E-File transfers available
New Accounts
  • Online Set-Up - click here to sign up now!
  • Personal presentations with compliance review to identify proper footwear needs.
  • Company specific websites.





  
 ACCOUNT SET-UP FORM
Company Name:
Account Number:
 CONTACT INFORMATION


Main Address


   

Billing Address   Same as Main Address


   

Shipping Address   Same as Billing Address


   

Company Phone Number
Phone Number:

Company Website
Website:

 ACCOUNT INFORMATION
Sales Representative:
# of Employees:
% Men:%
% Women:%
Tax Rate:%
Void:Span Duration


Authorized Deductions
Safety Footwear
Insoles
Clothing
Safety Glasses
Met-Guards
Puncture Resistant
ESD
Composite Toe
Soft Toe


Subsidy
Subsidy Type:
Subsidy Amount:
Subsidy Details:


Authorization Slip Information
Allow Payroll Deduction?
PD Form?
Authorizatione Form?
Send Invoice?
Leave @ Company?
PO Number Requiered?
PO Number:
Invoice Format:
Statement: - B2B Billing     - EFT     - Monthly    


Employee Classifications: (ie. Department, Cost Center, Account etc.)
Classification 1:
Classification 2:
  ACCOUNT CONTACT
*Name:(First/Middle/Last)
Employee Number:
*Phone: ext:
Fax:
Cell:
Email Address:
*Login Information
Password:
Password Confirm:
 
  ACCOUNTS PAYABLE CONTACT   Same as Account Contact
*Name:(First/Middle/Last)
Employee Number:
*Phone: ext:
Fax:
Cell:
Email Address:
*Login Information
Password:
Password Confirm:
 
  ADDITIONAL NOTES
 
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